Clinical Operations Group, HCA Healthcare, Nashville, Tennessee, USA.
J Hosp Med. 2022 Mar;17(3):169-175. doi: 10.1002/jhm.12789. Epub 2022 Feb 14.
Statins are a commonly used class of drugs, and reports have suggested that their use may affect COVID-19 disease severity and mortality risk.
The purpose of this analysis was to determine the effect of discontinuation of previous atorvastatin therapy in patients hospitalized for COVID-19 on the risk of mortality and ventilation.
Data from 146,413 hospitalized COVID-19 patients were classified according to statin therapy. Home + in hospital atorvastatin use (continuation of therapy); home + no in hospital atorvastatin use (discontinuation of therapy); no home + no in hospital atorvastatin use (no statins). Logistic regression was performed to assess the association between atorvastatin administration and either mortality or use of mechanical ventilation during the encounter.
Continuous use of atorvastatin (home and in hospital) was associated with a 35% reduction in the odds of mortality compared to patients who received atorvastatin at home but not in hospital (odds ratio [OR]: 0.65, 95% confidence interval [CI]: 0.59-0.72, p < .001). Similarly, the odds of ventilation were lower with continuous atorvastatin therapy (OR: 0.70, 95% CI: 0.64-0.77, p < .001).
Discontinuation of previous atorvastatin therapy is associated with worse outcomes for COVID-19 patients. Providers should consider maintaining existing statin therapy for patients with known or suspected previous use.
他汀类药物是一类常用药物，有报道称其使用可能会影响 COVID-19 疾病的严重程度和死亡风险。
本分析旨在确定 COVID-19 住院患者停止先前阿托伐他汀治疗对死亡率和通气的影响。
根据他汀类药物治疗情况对 146413 例住院 COVID-19 患者的数据进行分类。家庭 + 住院阿托伐他汀使用（继续治疗）；家庭 + 无住院阿托伐他汀使用（停止治疗）；无家庭 + 无住院阿托伐他汀使用（无他汀类药物）。使用逻辑回归评估阿托伐他汀给药与死亡率或在就诊期间使用机械通气之间的关联。
与在家中接受阿托伐他汀治疗但不在医院接受治疗的患者相比，连续使用阿托伐他汀（家庭和医院）可使死亡率降低 35%（优势比 [OR]：0.65，95%置信区间 [CI]：0.59-0.72，p < 0.001）。同样，连续使用阿托伐他汀治疗可降低通气的几率（OR：0.70，95% CI：0.64-0.77，p < 0.001）。
停止先前的阿托伐他汀治疗与 COVID-19 患者的不良结局相关。对于已知或疑似先前使用的患者，提供者应考虑维持现有的他汀类药物治疗。
